Use this calculator to determine the current Medicare hospice benefit period, its start and end dates, and the number of days remaining within that period based on the patient's initial hospice admission date.
Understanding Medicare Hospice Benefit Periods
Medicare's hospice benefit is designed to provide comfort and support to individuals with a terminal illness. It is structured into specific "benefit periods" to ensure ongoing eligibility and care. Understanding these periods is crucial for patients, families, and caregivers.
The Structure of Hospice Benefit Periods:
Two 90-Day Periods: Initially, Medicare covers two separate 90-day hospice benefit periods. These periods do not need to be consecutive.
Unlimited 60-Day Periods: After the two 90-day periods are exhausted, Medicare provides an unlimited number of subsequent 60-day benefit periods.
Recertification Requirement:
To continue hospice care beyond the initial periods and for each subsequent 60-day period, a hospice physician or nurse practitioner must recertify that the patient is still terminally ill (meaning they have a life expectancy of six months or less if the illness runs its normal course). This recertification ensures that the patient continues to meet Medicare's eligibility criteria for hospice care.
How the Calculator Works:
This calculator helps you determine which benefit period a patient is currently in, based on their initial hospice admission date and a specified calculation date. It will show:
Current Benefit Period: Identifies if it's the first 90-day, second 90-day, or a specific 60-day period.
Start Date of Current Period: The calendar date when the current benefit period began.
End Date of Current Period: The calendar date when the current benefit period is scheduled to end.
Days Remaining in Current Period: The number of days left until the current benefit period concludes.
Total Days in Hospice: The total number of days elapsed since the initial hospice start date up to the calculation date.
Important Considerations:
Breaks in Care: If a patient leaves hospice care and then returns, a new benefit period may begin, or they may resume an existing one, depending on the circumstances and the length of the break. This calculator assumes continuous care from the initial start date for simplicity.
Recertification: The calculator does not account for the recertification process itself. It only identifies the period. Actual continuation of benefits depends on physician recertification.
Eligibility: This tool is for informational purposes only and does not guarantee Medicare eligibility or coverage. Always consult with your hospice provider and Medicare for definitive information regarding your specific situation.
Examples:
Let's look at a few scenarios:
Example 1: Early in the First 90-Day Period
Initial Hospice Start Date: January 1, 2024
Date for Calculation: January 15, 2024
Result: The calculator would show the patient is in their "First 90-day period," which started on January 1, 2024, and ends on March 30, 2024. There would be approximately 75 days remaining. Total days in hospice: 14.
Example 2: Transitioning to the Second 90-Day Period
Initial Hospice Start Date: January 1, 2024
Date for Calculation: April 5, 2024
Result: The calculator would identify the "Second 90-day period," starting on March 31, 2024 (the day after the first 90-day period ended), and ending on June 28, 2024. There would be approximately 84 days remaining. Total days in hospice: 94.
Example 3: In a Subsequent 60-Day Period
Initial Hospice Start Date: January 1, 2024
Date for Calculation: August 10, 2024
Result: The calculator would show the patient is in their "2nd 60-day period" (after the two 90-day periods and the first 60-day period). This period would have started around August 2, 2024, and end around October 1, 2024. Days remaining would be approximately 52. Total days in hospice: 222.
This calculator is a helpful tool for planning and understanding the hospice benefit structure, but it should always be used in conjunction with professional advice from healthcare providers and Medicare representatives.
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function calculateHospiceBenefit() {
var initialHospiceStartDateStr = document.getElementById("initialHospiceStartDate").value;
var calculationDateStr = document.getElementById("calculationDate").value;
var resultDiv = document.getElementById("result");
// Clear previous results
resultDiv.innerHTML = "";
// Validate inputs
if (!initialHospiceStartDateStr || !calculationDateStr) {
resultDiv.innerHTML = "Please enter both the Initial Hospice Start Date and the Date for Calculation.";
return;
}
var initialHospiceStartDate = new Date(initialHospiceStartDateStr + "T00:00:00"); // Add T00:00:00 to ensure UTC interpretation for consistency
var calculationDate = new Date(calculationDateStr + "T00:00:00");
if (isNaN(initialHospiceStartDate.getTime()) || isNaN(calculationDate.getTime())) {
resultDiv.innerHTML = "Invalid date format. Please use YYYY-MM-DD.";
return;
}
if (calculationDate.getTime() < initialHospiceStartDate.getTime()) {
resultDiv.innerHTML = "The Date for Calculation cannot be before the Initial Hospice Start Date.";
return;
}
var oneDay = 1000 * 60 * 60 * 24; // milliseconds in one day
// Calculate total days elapsed from initial start date to calculation date
// We add 1 to include the calculation date itself in the count of days "in hospice"
var totalDaysInHospice = Math.floor((calculationDate.getTime() – initialHospiceStartDate.getTime()) / oneDay);
var currentPeriodType = "";
var currentPeriodStartDate = null;
var currentPeriodEndDate = null;
var daysRemaining = 0;
// Helper function to add days to a date
function addDays(date, days) {
var result = new Date(date);
result.setDate(result.getDate() + days);
return result;
}
// Determine the current benefit period
if (totalDaysInHospice < 90) {
// First 90-day period
currentPeriodType = "First 90-day period";
currentPeriodStartDate = initialHospiceStartDate;
currentPeriodEndDate = addDays(initialHospiceStartDate, 89); // Period ends on day 89, making it 90 days total (day 0 to day 89)
} else if (totalDaysInHospice < 180) {
// Second 90-day period
currentPeriodType = "Second 90-day period";
currentPeriodStartDate = addDays(initialHospiceStartDate, 90); // Starts on day 90
currentPeriodEndDate = addDays(initialHospiceStartDate, 179); // Ends on day 179
} else {
// Subsequent 60-day periods
var daysAfterInitialPeriods = totalDaysInHospice – 180;
var periodNumber = Math.floor(daysAfterInitialPeriods / 60) + 1; // 1st, 2nd, 3rd 60-day period etc.
var suffix = "th";
if (periodNumber % 10 == 1 && periodNumber % 100 != 11) {
suffix = "st";
} else if (periodNumber % 10 == 2 && periodNumber % 100 != 12) {
suffix = "nd";
} else if (periodNumber % 10 == 3 && periodNumber % 100 != 13) {
suffix = "rd";
}
currentPeriodType = periodNumber + suffix + " 60-day period";
var daysOffsetForCurrent60DayPeriodStart = 180 + (periodNumber – 1) * 60;
currentPeriodStartDate = addDays(initialHospiceStartDate, daysOffsetForCurrent60DayPeriodStart);
currentPeriodEndDate = addDays(currentPeriodStartDate, 59); // 60 days total (day 0 to day 59)
}
// Calculate days remaining in the current period
daysRemaining = Math.round((currentPeriodEndDate.getTime() – calculationDate.getTime()) / oneDay);
// Format dates for display
var options = { year: 'numeric', month: 'long', day: 'numeric' };
var formattedInitialStartDate = initialHospiceStartDate.toLocaleDateString('en-US', options);
var formattedCalculationDate = calculationDate.toLocaleDateString('en-US', options);
var formattedPeriodStartDate = currentPeriodStartDate.toLocaleDateString('en-US', options);
var formattedPeriodEndDate = currentPeriodEndDate.toLocaleDateString('en-US', options);
var resultHTML = "
Benefit Period Details:
";
resultHTML += "Initial Hospice Start Date: " + formattedInitialStartDate + "";
resultHTML += "Date for Calculation: " + formattedCalculationDate + "";
resultHTML += "Total Days in Hospice (as of calculation date): " + (totalDaysInHospice + 1) + " days"; // +1 to include the start day
resultHTML += "Current Benefit Period: " + currentPeriodType + "";
resultHTML += "Start Date of Current Period: " + formattedPeriodStartDate + "";
resultHTML += "End Date of Current Period: " + formattedPeriodEndDate + "";
if (daysRemaining >= 0) {
resultHTML += "Days Remaining in Current Period: " + daysRemaining + " days";
} else {
resultHTML += "Current Period Status: This period ended " + Math.abs(daysRemaining) + " days ago. A new benefit period would have started or recertification is required.";
}
resultDiv.innerHTML = resultHTML;
}
// Set default date for calculationDate to today
document.addEventListener('DOMContentLoaded', function() {
var today = new Date();
var dd = String(today.getDate()).padStart(2, '0');
var mm = String(today.getMonth() + 1).padStart(2, '0'); //January is 0!
var yyyy = today.getFullYear();
document.getElementById('calculationDate').value = yyyy + '-' + mm + '-' + dd;
});